Health Risk Screening

Medicaid Plan:

1. Are you pregnant?

2. How would you rate your overall health?

3. Do you have a primary care doctor?

Do you have trouble getting to the doctor for checkups or sick visits?

Do you need help making an appointment with your doctor?

4. Are you taking any prescription medicines?

How many?

Do you have any trouble getting your medicines?

Would you like help managing this condition?

6. Do you have any mental health conditions that make it difficult to perform daily tasks, or feel really stressed, worried or sad?

Are you getting help for these feelings?

Do you want help with these feelings?

7. Do you currently smoke or use tobacco products?

Do you want help quitting tobacco?

8. Do you drink alcohol?

Do you want help stopping drinking?

9. Do you use recreational or non-prescribed drugs?

Do you want help stopping using drugs?

10. Have you had two or more emergency room or inpatient hospital stays in the last 6 months?

11. Do you need help with everyday things like getting dressed, taking a bath, eating or using the bathroom?

Do you have someone that helps you enough today?

Would you like a Care Manager to contact you for help with everyday things?

12. Do you have a safe place to live and enough food to eat every day?

13. Do you feel connected to the community?

Would you like to be connected to a community group for events, volunteering opportunities, referrals, or scheduling assistance to access community support services?

14. Do you work?

Does your job offer insurance?

Do you want to learn new skills or get help finding a job?

15. Is difficulty paying your bills putting your family in an unsafe situation?

Health Quiz

Part 1: General Health and Utilization

Part 2: Pathway to Prosperity Screening

Part 3: Closing